1. In a petition lodged with the
Inter-American Commission on Human Rights (hereinafter “the Commission,”
“the Inter-American Commission,” or “the IACHR”) on June 15, 1999, the
nongovernmental organizations Office for the Defense of Women’s Rights (DEMUS),
the Latin American and Caribbean Committee for the Defense of Women’s
Rights (CLADEM), and the Asociación Pro Derechos Humanos
[Association for Human Rights] (APRODEH), which subsequently accredited
as co-petitioners the Center for Reproductive Law and Policy (CRLP) and
the Center for Justice and International Law (CEJIL), (hereinafter “the
petitioners”), alleged that the Republic of Peru (hereinafter “Peru”)
violated the human rights of Ms. María Mamérita Mestanza Chávez, by
forced sterilization that ultimately caused her death.

2. The original petitioners alleged
that the facts denounced constitute violation by the Peruvian State of
the rights to life, personal integrity, and equality before the law,
contained in Articles 4, 5, 1, and 24 of the American Convention on
Human Rights (hereinafter “the Convention” or “the American
Convention”), and violation of Articles 3, 4, 7, 8, and 9 of the
Inter-American Convention on the Prevention, Punishment, and Eradication
of Violence Against Women (hereinafter “the Convention of Belém do
Pará”), Articles 3 and 10 of the Additional Protocol to the American
Convention on Human Rights in the Area of Economic, Social, and Cultural
Rights (hereinafter “the Protocol of San Salvador.”) and Articles 12 and
14(2) of the Convention on the Elimination of All Forms of
Discrimination Against Women (CEDAW).

3. On February 22, 2001, the
Peruvian State signed a joint press release with the Inter-American
Commission on Human Rights, in which it was agreed to pursue friendly
settlement of some cases before the Commission, including this one, in
accordance with Articles 48(1)(f) and 49 of the American Convention on
Human Rights.

4. On March 2, 2001, during the 110th
session of the Inter-American Commission on Human Rights, the Peruvian
State and the victims’ representatives signed the Preliminary Agreement
for Friendly Settlement with intervention and approval by the IACHR. The
final friendly settlement was agreed upon on August 26, 2003, when the
act setting out the friendly settlement reached by the parties was
signed in Lima.

5. This friendly settlement report,
pursuant to Article 49 of the Convention and Article 41.5 of the
Commission’s Regulations, presents a brief summary of the facts alleged
by the petitioners, the friendly solution reached, and agreement for its
publication.

II. PROCESSING WITH THE
COMMISSION

6. The Commission received the claim
on June 15, 1999. On July 14, 1999 the IACHR opened the case,
transmitted pertinent parts of the petition to the Peruvian State, and
requested information within 90 days. Peru asked for additional time to
prepare its reply, which was approved by the IACHR. Peru replied on
January 14, 2000. The petitioners made comments on the State’s reply on
April 12, 2000. On October 3, 2000 the Inter-American Commission on
Human Rights approved the Report on Admissibility
Nº 66/00.

7. On March 2, 2001, with
intervention and approval by the Inter-American Commission on Human
Rights, the parties signed the Preliminary Agreement for Friendly
Settlement, in which the Peruvian State admitted its international
responsibility for the acts alleged by the petitioners and promised to
take the necessary measures to compensate the victims.

8. On August 26, 2003, in the city
of Lima, the representatives of the victims and the State signed the
Agreement for Friendly Settlement, requesting that the Commission ratify
the entire contents.

III. FACTS

9. They alleged that the case of Ms.
María Mamérita Mestanza is one more among a large number of cases of
women affected by a massive, compulsory, and systematic government
policy to stress sterilization as a means for rapidly altering the
reproductive behavior of the population, especially poor, Indian, and
rural women. They noted that the Ombudsman had received several
complaints on this matter, and that between November 1996 and November
1998 CLADEM had documented 243 cases of human rights violations through
the performance of birth control surgery in Peru.

10. They stated that Ms. María
Mamérita Mestanza, a rural woman about 33 years old and mother of seven
children, was pressured to accept sterilization starting in 1996 by the
Health Center of Encañada District. She and her husband Jacinto Salazar
Suárez were subjected to various forms of harassment, including several
visits in which health personnel threatened to report her and Mr.
Salazar Suárez to the police, and told them that the government had
approved a law requiring anyone who had more than five children to pay a
fine and go to jail.

11. They state that finally, under
coercion, Ms. Mestanza agreed to have tubal ligation surgery. The
procedure was performed on March 27, 1988 at the Cajamarca Regional
Hospital, without any pre-surgery medical examination. Ms. Mestanza was
released the next day, March 28, 1988, although she had serious symptoms
including nausea and sharp headaches. In the following days Mr. Jacinto
Salazar reported to personnel of La Encañada Health Center on Ms.
Mestanza’s condition, which worsened daily, and was told by them that
this was due to post-operative effects of the anesthesia.

12. They state that Ms. Mestranza
Chavez died at home on April 5, 1998, and that the death certificate
specified a “sepsis” as the direct cause of death and bilateral tubal
blockage as a precedent cause. They report that a few days later a
doctor from the Health Center offered a sum of money to Mr. Jacinto
Salazar in an effort to put an end to the matter.

13. They indicate that on April 15,
1998 Mr. Jacinto Salazar filed charges with the Provisional Combined
Prosecutor of Baños del Inca against Martín Ormeño Gutiérrez, Chief of
La Encañada Health Center, in connection with the death of Ms. Mestanza,
for crimes against life, body, and health, in premeditated homicide (first
degree murder). They add that on May 15, 1998 this Provincial Prosecutor
indicted Mr. Ormeño Gutiérrez and others before the local Provincial
Judge, who on June 4, 1998 ruled that there were insufficient grounds to
prosecute. This decision was confirmed on July 1, 1998 by the Circuit
Criminal Court, so on December 16, 1998 the Provincial Prosecutor
ordered the case dismissed.

IV. FRIENDLY SETTLEMENT

14. The State and the petitioner
signed the friendly settlement agreement, the text of which follows:

FIRST: BACKGROUND

Ms. María Mamérita Mestanza Chávez was
forced to undergo sterilization surgery, which ultimately resulted in
her death. The petitioner organizations allege that her rights to life,
personal integrity, and equality before the law were violated, in
contravention of Articles 4, 5, 1, and 24 of the American Convention on
Human Rights, Articles 3, 4, 7, 8, and 9 of the Inter-American
Convention on the Prevention, Punishment, and Eradication of Violence
Against Women (Convention of Belém do Pará), Articles 3 and 10 of the
Additional Protocol to the American Convention on Human Rights in the
Area of Economic, Social, and Cultural Rights, and Articles 12 and 14.2
of the Convention on the Elimination of All Forms of Discrimination
Against Women.

On July 14, 1999 the Inter-American
Commission on Human Rights transmitted the pertinent parts of the
complaint to the Peruvian State and requested information. On October 3,
2000 the IACHR approved Report No. 66/00 on admissibility, and continued
reviewing the substance of the case, concerning alleged violations of
the American Convention and the Convention of Belém do Pará.

On March 2, 2001 during the 110th
regular session of the IACHR a Preliminary Agreement for Friendly
Settlement was reached.

SECOND: RECOGNITION

The Peruvian State, aware that protection
and total respect for human rights is the cornerstone for a just,
honorable, and democratic society, in strict compliance with its
obligations assumed with the signing and ratification of the American
Convention on Human Rights and other international human rights
instruments to which it is a party, and aware that any violation of an
international obligation that results in injury brings with it the duty
for adequate reparation, which can most justly be done through
compensation of the victim, investigation of the facts, and
administrative, civil, and criminal penalties for the responsible
parties, recognizes its international responsibility for the violation
of Articles 1.1, 4, 5, and 24 of the American Convention on Human Rights,
as well as Article 7 of the Inter-American Convention on the Prevention,
Punishment, and Eradication of Violence Against women in the harm done
to victim María Mamérita Merstanza Chávez.

This recognition was reflected in the
Preliminary Agreement for Friendly Settlement signed between the
Peruvian State and the victim’s legal representatives, with intervention
and approval by the Inter-American Commission on Human Rights, on March
2, 2001 during the 110th session of the Inter-American
Commission on Human Rights. In that agreement the Peruvian State
admitted international responsibility for the facts described and
pledged to take steps for material and moral reparation of the harm done
and to initiate a thorough investigation and trial of the perpetrators
and take steps to prevent the recurrence of similar incidents in the
future.

THIRD: INVESTIGATION AND PUNISHMENT

The Peruvian State promises to make a
thorough investigation of the facts and apply legal punishments to any
person determined to have participated in them, as either planner,
perpetrator, accessory, or in other capacity, even if they be civilian
or military officials or employees of the government.

In this regard, the Peruvian State pledges
to carry out administrative and criminal investigations into the attacks
on the personal liberty, life, body, and health of the victim, and to
punish:

a. Those responsible for the acts
of pressuring the consent of Ms. María Mamérita Mestanza Chávez to
submit to tubal ligation.

b. The health personnel who
ignored the need for urgent care for Ms. Mestanza after her surgery.

c. Those responsible for the
death of Ms. María Mamérita Mestanza Chávez.

d. The doctors who gave money to
the spouse of the deceased woman in an attempt to cover up the
circumstances of her demise.

e. The Investigative Commission,
named by Cajamara Sub-Region IV of the Health Ministry, which
questionably exonerated the health personal from responsibility for Ms.
Mestanza’s death.

Apart from the administrative and criminal
penalties, the Peruvian state pledges to report any ethical violations
to the appropriate professional association so that it can apply
sanctions to the medical personnel involved in these acts, as provided
in its statutes.

In addition, the State pledges to conduct
administrative and criminal investigations into the conduct of agents of
the Office of Public Prosecution and the judicial branch who failed to
take action to clarify the facts alleged by Ms. Mamérita Mestanza’s
widower.

The Peruvian State awards one-time
compensation to each of the beneficiaries of ten thousand U.S. dollars
($10,000.00) for reparation of moral injury, which totals eighty
thousand U.S. dollars ($80,000.00).

The State will deposit the amount due the
minors in a trust account in accordance with the best terms available
under sound banking practice. Arrangements will be made jointly with the
Salazar Mestanza family’s legal representatives.

b. Corollary damages

Injury caused as a direct consequence of
the event giving rise to the claim consists of expenses incurred by the
family as a direct result of the acts. These expenses were incurred to
file and follow-up criminal charges with the Office of Public
Prosecutions for aggravated homicide of María Mamérita Mestanza, as well
as the costs of Ms. Mestanza’s funeral and burial. The amount expended
for these purposes is two thousand U.S. dollars ($2,000.00), which the
Peruvian State shall pay to the beneficiaries.

FIFTH: INDEMNIFICATION FROM THOSE
CRIMINALLY RESPONSIBLE FOR THE ACTS

The Agreement for Peaceful Settlement does
not include the beneficiaries’ right to damages from all those
responsible for violation of Ms. María Mamérita Mestanza’s human rights,
as determined by a competent court in accordance with Article 92 of the
Peruvian Penal Code, a right which is recognized by the Peruvian State.
This agreement expressly waives any other claim by the beneficiaries
against the Peruvian State as responsible party, a co-defendant, or in
any other capacity.

SIXTH: RIGHT OF RECOVERY

The Peruvian State reserves the right of
recovery against all persons found to be responsible in this case
through the definitive sentence of a competent national tribunal, in
accordance with current domestic law.

SEVENTH: TAX EXEMPTION, COMPLIANCE, AND
LATE PENALTY

The damages awarded by the Peruvian State
shall not be subject to payment of any present or future tax, assessment,
or fee, and shall be paid no later than six months after the
Inter-American Commission on Human Rights has sent notification of this
agreement’s ratification, after which the State shall pay the maximum
late fee and interest required or permitted by domestic legislation.

EIGHTH: MEDICAL PAYMENTS

The Peruvian State promises to make a
one-time payment to the beneficiaries of seven thousand U.S. dollars
($7,000.00) for psychological rehabilitation treatment they require as a
result of the death of María Mamérita Mestanza Chávez. That sum shall be
paid in trust to a public or private institution, designated as the
trustee, which will administer the resources spent on providing
psychological care needed by the beneficiaries. The institution will be
chosen jointly by the State and representatives of the Salazar Mestanza
family, with support from the National Human Rights Coordination, DEMUS,
APRODEH, and the Archbishop of Cajamarca. Expenses for legal
establishment of the trust shall be paid by the Peruvian State.

In addition, the Peruvian State promises
to give the husband and children of María Mamérita Mestanza Chávez
permanent health insurance with the Ministry of Health or other
competent entity. The surviving spouse’s health insurance will be
permanent, as will that of the children until they have their own public
and/or private coverage.

NINTH: EDUCATION PAYMENTS

The Peruvian State promises to give the
victim’s children free primary and secondary education in public schools.
The victim’s children will receive tuition-free university education for
a single degree at state schools, provided they qualify for admission.

TENTH: OTHER PAYMENTS

The Peruvian State agrees to make an
additional payment of twenty thousand U.S. dollars ($20,000.00) to Mr.
Jacinto Salazar Suárez to buy land or a house in the name of the
children he had with Ms. María Mamérita Mestanza. Within one year of the
date of this agreement Mr. Salazar Suárez must register the purchase by
delivering the deed to the Executive Secretariat of the National Human
Rights Council of the Ministry of Justice. Furthermore, Mr. Salazar
Suárez agrees not to sell or lease the property purchased until the
youngest of his children is of legal age, unless authorized by the
court.

Peru’s National Coordinator of Human
Rights will be responsible for the necessary follow-up to ensure
compliance with the provisions of this clause.

ELEVENTH: CHANGES IN LAWS AND PUBLIC
POLICIES ON REPRODUCTIVE HEALTH AND FAMILY PLANNING

The Peruvian State pledges to change laws
and public policies on reproductive health and family planning,
eliminating any discriminatory approach and respecting women’s autonomy.

The Peruvian State also promises to adopt
and implement recommendations made by the Ombudsman concerning public
policies on reproductive health and family planning, among which are the
following:

a. Penalties for human rights
violators and reparation for victims

1) Conduct a judicial review of
all criminal cases on violations of human rights committed in the
execution of the National Program of Reproductive Health and Family
Planning, to break out and duly punish the perpetrators, requiring them
to pay the appropriate civil damages, including the State if it is
determined to have some responsibility for the acts that gave rise to
the criminal cases.

2) Review the administrative
proceedings initiated by the victims and/or their family members, linked
to the cases in the previous paragraph, which are pending or have
concluded concerning denunciations of human rights violations.

b. Methods for monitoring and
guaranteeing respect for human rights of health service clients

1) Adopt drastic measures against
those responsible for the deficient pre-surgery evaluation of women who
undergo sterilization, including health professionals in some of the
country’s health centers. Although the rules of the Family Planning
Program require this evaluation, it is not being done.

3) Adopt the necessary
administrative measures so that that rules established for ensuring
respect for the right of informed consent are scrupulously followed by
health personnel.

4) Guarantee that the centers that
offer sterilization surgery have proper conditions required by standards
of the Family Planning Program.

5) Take strict measures to ensure
that the compulsory reflection period of 72 hours is faithfully and
universally honored.

6) Take drastic action against
those responsible for forced sterilization without consent.

7) Implement a mechanism or
channels for efficient and expeditious receipt and processing of
denunciations of violation of human rights in the health establishments,
in order to prevent or redress injury caused.

TWELFTH: LEGAL BASIS

This agreement is signed in accordance
with the provisions of Articles 1, 2, and 48.1.f of the American
Convention on Human Rights and Article 41 of the Regulations of the
Inter-American commission on Human Rights; on Articles 2 (paragraphs 1
and 24, point 8), 44, 55, 205 and fourth final provision of Peru’s
Constitution; and on the provisions of Articles 1205, 1306, 1969, and
1981 of the Civil Code of Peru.

THIRTEENTH: INTERPRETATION

The meaning and scope of this agreement
will be interpreted in accordance with Article 29 and 30 of the American
Convention on Human Rights as applicable, and the principle of good
faith. In case of doubt or disagreement between the parties on the
content of this agreement, the Inter-American Commission on Human Rights
shall resolve the interpretation. It shall also be responsible for
monitoring the agreement’s compliance; the parties shall report to it
every three months on the status of compliance.

FOURTEENTH: HOMOLOGATION

The parties hereto agree to refer this
Agreement for Friendly Settlement to the Inter-American Commission on
Human Rights for confirmation and ratification of all aspects.

FIFTEENTH: ACCEPTANCE

The parties signing this agreement express
their free and voluntary acceptance of and concurrence with each and
every one of its clauses, stating for the record that it resolves the
dispute and any claim regarding the international responsibility of the
Peruvian State for violation of the human rights of Ms. María Mamérita
Mestanza Chávez.

Signed with three copies in the City of
Lima this twenty-sixth day of August of the year two thousand three.

V. DETERMINATION OF COMPATIBILITY AND
COMPLIANCE

15. The IACHR reiterates that as
provided in Articles 48.1.f and 49 of the Convention, this procedure is
intended for “reaching a friendly settlement of
the matter on the basis of respect for the human rights recognized in
the Convention.”[GDM1]
Agreement to follow this procedure reflects the State’s good will to
comply with the purposes and objectives of the Convention by virtue of
the pacta sunt servanda principle, according to which states must
show good faith in honoring obligations assumed in treaties. It also
wishes to reiterate that the friendly settlement procedure contemplated
in the Convention permits settlement of individual cases without
recourse to litigation, and has demonstrated in the case of several
countries that it is an important tool for solution that can be used by
both parties.

16. The Inter-American Commission has
closely followed development of the friendly settlement reached in this
case. The Commission greatly appreciates the effort shown by both
parties to reach a solution that is compatible with the objective and
purpose of the Convention. As the Commission has said repeatedly,
protection and promotion of women’s rights is a priority for our
hemisphere, in order that women may attain the full and effective
enjoyment of their basic rights, especially equality, nondiscrimination,
and living free from gender-based violence.

VI. CONCLUSIONS

17. On the basis of the preceding
considerations, and by virtue of the proceeding envisioned in Articles
48.1.f and 49 of the American Convention, the Commission wishes to
reiterate its deep appreciation for the parties’ efforts and its
satisfaction with the friendly settlement agreement reached in this case
in keeping with the objective and purpose of the American Convention.

18. Taking into account the
considerations and conclusions expressed in this report,

THE INTER-AMERICAN COMMISSION ON HUMAN
RIGHTS,

DECIDES:

1. To approve the terms of the
Agreement for Friendly Settlement signed by the parties on August 26,
2003.

2. To continue following up and
monitoring each and every point of the friendly settlement, and in this
context to remind the parties of their obligation to submit reports to
the IACHR every three months on compliance with this agreement.

3. To publish this report and
include it in its annual report to the OAS General Assembly.

Done and signed at the
headquarters of the Inter-American Commission on Human Rights in the
city of Washington, D.C., on the 22nd day of the month of
October, 2003. (Signed): José Zalaquett, President; Clare K. Roberts,
First Vice-President; Robert K.
Goldman and Julio Prado Vallejo, Commissioners.

[1]
Pursuant to the provisions of Article 17(2)(a) of the Commission’s
Regulations, Commissioner Susana Villarán, of Peruvian nationality,
did not participate in the consideration or decision of this case.